Dialysis systems having spiraling fluid air separation chambers

ABSTRACT

A dialysis fluid cassette includes a rigid portion defining at least one valve chamber, the rigid portion further defining an air separation chamber, the air separation chamber when in an operating position including an inner surface, a fluid inlet and a fluid outlet and configured to cause a dialysis fluid to spiral around the inner surface toward the fluid outlet, such that air is removed from the dialysis fluid.

PRIORITY CLAIM

This application is a continuation of, claims priority to and thebenefit of U.S. patent application Ser. No. 11/865,552, filed Oct. 1,2007, the entire contents of which are incorporated herein by referenceand relied upon.

BACKGROUND

The examples discussed below relate generally to medical fluid delivery.More particularly, the examples disclose systems, methods andapparatuses for dialysis such as hemodialysis (“HD”) automatedperitoneal dialysis (“APD”).

Due to various causes, a person's renal system can fail. Renal failureproduces several physiological derangements. It is no longer possible tobalance water and minerals or to excrete daily metabolic load. Toxic endproducts of nitrogen metabolism (urea, creatinine, uric acid, andothers) can accumulate in blood and tissue.

Kidney failure and reduced kidney function have been treated withdialysis. Dialysis removes waste, toxins and excess water from the bodythat normal functioning kidneys would otherwise remove. Dialysistreatment for replacement of kidney functions is critical to many peoplebecause the treatment is life saving.

One type of kidney failure therapy is Hemodialysis (“HD”), which ingeneral uses diffusion to remove waste products from a patient's blood.A diffusive gradient occurs across the semi-permeable dialyzer betweenthe blood and an electrolyte solution called dialysate to causediffusion. Hemofiltration (“HF”) is an alternative renal replacementtherapy that relies on a convective transport of toxins from thepatient's blood. This therapy is accomplished by adding substitution orreplacement fluid to the extracorporeal circuit during treatment(typically ten to ninety liters of such fluid). That substitution fluidand the fluid accumulated by the patient in between treatments isultrafiltered over the course of the HF treatment, providing aconvective transport mechanism that is particularly beneficial inremoving middle and large molecules (in hemodialysis there is a smallamount of waste removed along with the fluid gained between dialysissessions, however, the solute drag from the removal of thatultrafiltrate is not enough to provide convective clearance).

Hemodiafiltration (“HDF”) is a treatment modality that combinesconvective and diffusive clearances. HDF uses dialysate flowing througha dialyzer, similar to standard hemodialysis, to provide diffusiveclearance. In addition, substitution solution is provided directly tothe extracorporeal circuit, providing convective clearance.

Most HD (HF, HDF) treatments occur in centers. A trend towards homehemodialysis (“HHD”) exists today in part because HHD can be performeddaily, offering therapeutic benefits over in-center hemodialysistreatments, which occur typically bi- or tri-weekly. Studies have shownthat a patient receiving more frequent treatments removes more toxinsand waste products than a patient receiving less frequent but perhapslonger treatments. A patient receiving more frequent treatments does notexperience as much of a down cycle as does an in-center patient who hasbuilt-up two or three days worth of toxins prior to a treatment. Incertain areas, the closest dialysis center can be many miles from thepatient's home causing door-to-door treatment time to consume a largeportion of the day. HHD can take place overnight or during the day whilethe patient relaxes, works or is otherwise productive.

Another type of kidney failure therapy is peritoneal dialysis, whichinfuses a dialysis solution, also called dialysate, into a patient'speritoneal cavity via a catheter. The dialysate contacts the peritonealmembrane of the peritoneal cavity. Waste, toxins and excess water passfrom the patient's bloodstream, through the peritoneal membrane and intothe dialysate due to diffusion and osmosis, i.e., an osmotic gradientoccurs across the membrane. The spent dialysate is drained from thepatient, removing waste, toxins and excess water from the patient. Thiscycle is repeated.

There are various types of peritoneal dialysis therapies, includingcontinuous ambulatory peritoneal dialysis (“CAPD”), automated peritonealdialysis (“APD”), tidal flow dialysate and continuous flow peritonealdialysis (“CFPD”). CAPD is a manual dialysis treatment. Here, thepatient manually connects an implanted catheter to a drain to allowspent dialysate fluid to drain from the peritoneal cavity. The patientthen connects the catheter to a bag of fresh dialysate to infuse freshdialysate through the catheter and into the patient. The patientdisconnects the catheter from the fresh dialysate bag and allows thedialysate to dwell within the peritoneal cavity, wherein the transfer ofwaste, toxins and excess water takes place. After a dwell period, thepatient repeats the manual dialysis procedure, for example, four timesper day, each treatment lasting about an hour. Manual peritonealdialysis requires a significant amount of time and effort from thepatient, leaving ample room for improvement.

Automated peritoneal dialysis (“APD”) is similar to CAPD in that thedialysis treatment includes drain, fill and dwell cycles. APD machines,however, perform the cycles automatically, typically while the patientsleeps. APD machines free patients from having to manually perform thetreatment cycles and from having to transport supplies during the day.APD machines connect fluidly to an implanted catheter, to a source orbag of fresh dialysate and to a fluid drain. APD machines pump freshdialysate from a dialysate source, through the catheter and into thepatient's peritoneal cavity. APD machines also allow for the dialysateto dwell within the cavity and for the transfer of waste, toxins andexcess water to take place. The source can include multiple steriledialysate solution bags.

APD machines pump spent dialysate from the peritoneal cavity, though thecatheter, and to the drain. As with the manual process, several drain,fill and dwell cycles occur during dialysis. A “last fill” occurs at theend of APD and remains in the peritoneal cavity of the patient until thenext treatment.

In any of the above modalities, entrained air and other gases are aconcern. Entrained air can cause inaccuracies when pumping dialysate foreither PD or HD. Entrained air entering a patient's peritoneum during PDcan cause discomfort. Entrained air entering a patient's bloodstreamduring HD can have severe consequences. Accordingly, a need exists toprovide an apparatus that ensures that entrained air is removed fromdialysate or blood prior to delivering such fluids to the patient.

SUMMARY

The present disclosure relates to air and gas removal for dialysissystems. The structures disclosed herein can be performed in any type ofperitoneal dialysis treatment or blood dialysis treatment such ashemodialysis, hemofiltration, hemodiafiltration and continuous renalreplacement therapy. The embodiments below are disclosed in connectionwith a dialysis disposable that is loaded into a dialysis instrument.The dialysis disposable is part of an overall dialysis set which caninclude one or more supply bag, one or more drain bag, a heater bag andassociated tubing connecting the bags to the dialysis disposable. Theuser places the dialysis disposable within the dialysis instrument fortherapy. The dialysis disposable can include one or more pump chamber,flow path and/or valve chamber. The dialysis instrument includes one ormore pump actuator that actuates the pump chamber of the disposable. Thedialysis instrument also includes one or more valve actuator thatactuates the valve chamber of the disposable. The disposable can alsoinclude a fluid heating pathway that operates with a fluid heater of thedialysis instrument.

While the air traps are shown herein in connection with a disposable setdescribed below, the separation chambers are alternatively stand-aloneapparatuses that operate independent of the disposable. Further, thepresent disclosure mainly discusses air but other gases can also bepresent and therefore the present air separation chambers can also trapthese gases. In PD for example, gases from the patient can becomeentrained in fluid being pumped form the system. Also, gases fromdialysate concentrate, such as bicarbonate can become entrained in freshdialysate. It is expressly contemplated for the air separation chambersof the present disclosure to remove these additional types of gases.

As mentioned above, air in dialysate or dialysis fluid as well as air inblood needs to be removed before any of these fluids are eitherdelivered to a dialyzer or patient. Air can be present in the system viaair trapped in supply bags, air trapped in the tubes leading from thesupply bags to the disposable, air not completely primed from thedisposable itself and air that is released from solution when thedialysis fluid is heated. Air can also signal a leak in the disposableunit.

The air traps discussed below are shown generally in connection with adialysis fluid, such as dialysate, having entrained air. It should beappreciated however that the embodiments are applicable equally to theremoval of air from blood pumped from a patient to a hemodialyzer orhemofilter. As used herein, the term dialysis fluid includes, withoutlimitation, mixed dialysate, mixed infusate, mixed replacement fluid,concentrated components of any of these, and blood.

In one embodiment, the disposable defines an air separation chamber thathas a fluid inlet and a fluid outlet. An inlet valve and an outlet valveare paired with the fluid inlet and fluid outlet of the air separationchamber, respectively. The air separation chamber also includes an airvent outlet, which is in fluid communication with one or more air ventvalve. The air removed from fluid in the air trap is sent to atmosphereor to a drain, for example, whichever is desired.

In one embodiment, the air separation chamber is configured with respectto the other components of the disposable such that when the disposableis loaded into the dialysis instrument, at least one of the fluid inletand fluid outlet are located towards a bottom or bottom wall of the airseparation chamber, while the air outlet is located at or near the topof the dialysis instrument. The inlet and out are likely located belowthe air outlet. Such configuration allows buoyancy forces to lift airbubbles from the dialysis fluid to the top of the air separation chamberfor venting.

The dialysis disposable in one embodiment includes a cassette having arigid portion, which can be a hard plastic. The rigid portion is formedto have pump chambers (e.g., for diaphragm pumps) or pump tubing (forperistaltic pumping), fluid pathways and valve chambers. The rigidportion also defines some or all of the air separation chamber. It iscontemplated that the disposable cassette will have flexible sheetingwelded to one or both sides of the rigid portion of the cassette. Theflexible sheeting allows a pneumatic or mechanical force to be appliedto the pump chambers (e.g., diaphragm) and valve chambers to operatethose chambers. It is also contemplated that at least one outer surfaceof the air separation chamber consume a portion of one or both flexiblesheets.

The disposable cassette can have a base wall or mid-plane that dividesthe cassette into first and second sides. For example, in one embodimentthe flow paths are provided on one side of the disposable cassette (oneside of the base wall), while the pump and valve chambers are providedon the other side of the disposable cassette. The air separation chamberin one embodiment is provided on either the first or second side,whichever is more convenient. Here, the air separation chamber has oneside surface that is the rigid mid-plane and a second side surface thatis cassette sheeting, which is welded to an air separation chamber inletwall, an air separation chamber outlet wall, an air separation chambertop wall and an air separation chamber bottom wall, which each extendsfrom and is formed with the mid-plane of the rigid portion.

It is expressly contemplated however to make the outer wall of thedisposable cassette of a rigid material as opposed to cassette sheeting.For example, a rigid piece of plastic could be welded, adhered orotherwise bonded sealingly to the air separation walls extending fromthe mid-plane of the rigid portion.

In still a further alternative embodiment, the mid-plane is not presentwithin the air separation chamber, and the air separation chamber isbonded on two sides by flexible sheeting. Still further alternatively,the mid-plane is not provided, however the outer walls of the airseparation chamber are rigid and adhere to the top, bottom, inlet andoutlet walls via a suitable sealing process.

The air separation chamber in one embodiment includes an inlet thatcauses the dialysis fluid to fall from the inlet, like a fountain, intoa pool of dialysis fluid which degasses before flowing out a bottom ofthe air separation chamber. The air separation chamber provides a dualprong attack to pull gas bubbles from air. First, the fountain-likeinlet of the dialysis fluid causes the fluid to separate, exposing alarge surface area of fluid to air and mixing the dialysis fluid to helpseparate bubbles from the fluid. Second, the pooling of the dialysisfluid enables buoyancy forces to push air bubbles out of the fluid.

In one implementation shown below, dialysis fluid flows upwardly througha centrally located fluid inlet. The fluid bubbles out of the inlet,pools at a level below the inlet and exits one or more outlet located atthe bottom of the air separation chamber (when placed in an operatingposition).

In another implementation shown below, dialysis fluid flows upwardlythrough an inlet located at one side of the air separation chamber. Thefluid bubbles out of the inlet, pools at a level below the inlet andexits at an outlet located at the bottom and opposite side of the airseparation chamber (when placed in an operating position). A rampedsurface is provided from the outlet located at one side of the chamberto the inlet located at the other side of the chamber.

In a further implementation shown below, dialysis fluid flowshorizontally out of an inlet located at one side of and nearer to thetop of the air separation chamber. A splash wall is provided near theinlet opening. The fluid flows out of the inlet, hits the splash wall,and pools at a level below the inlet, and exists at an outlet located atthe bottom and same side of the air separation chamber as the inlet(when placed in an operating position). The bottom of the chamber can beramped downwardly towards the outlet.

In another embodiment, the air separation chamber combines buoyancyforces with a cyclone formed within the chamber to remove gas bubblesupwardly from within a center of the cyclone formed in the airseparation chamber. In an embodiment, fluid enters the air trapeccentrically and spirals downwardly to the outlet, and air bubbles arecollected in the center of the cyclone and degassed at the top of thechamber.

The cyclone is formed in one embodiment by staggering ramps within asubstantially rectangular chamber formed in the air separation chamber.The ramps can form central openings allowing gas to proceed up themiddle of the cyclone. The ramps are alternatively partitioned such thatthe dialysis fluid swirls back and forth from side to side within thecassette and such that a gap is left between the partitioned ramps forair bubbles to rise. Two such partitioned spiraling sets of ramps can beprovided to form a pair of intertwined spiral flow paths having acentral air removal channel in the shared center of the flow paths.

Further alternatively, the air separation chamber can include sides madeof flexible sheeting as mentioned above which can be sucked againstchamber halves formed in the dialysis instrument. The chamber halves canbe configured to cooperate with sides of the dialysis cassette that arealso shaped to form, with the instrument chamber halves, a relativelylarge elliptical or oval shaped volume that is conducive to forming thespiral or cyclone path. Here, the dialysis fluid spins from top tobottom of the air separation chamber, allowing air to degas up themiddle of the cyclone.

In a further alternative embodiment, the air separation chamber uses aventuri effect to pull air out of the dialysis fluid. Here, the inlet ofthe air separation chamber nozzles down to a neck. An air trap orcollection bulb is placed at the neck. The fluid accelerates when itreaches the neck and flows by the air trap or collection bulb whichgenerates a vacuum in the bulb, pulling air from the dialysis fluid.

In yet another alternative embodiment, the air separation chamber isconfigured to force dialysis fluid through a narrow fluid film-formingsection which induces a narrow or film-like flow of the dialysis fluid.The film-like flow spills into a pool of fluid. The film increases thesurface area of the fluid that is exposed to air, promoting removal ofair from the fluid to atmosphere. Air that reaches the pool is forcedfrom the pool via buoyancy.

For any of the embodiments described herein, the air separation chambercan provide a filter or mesh for catching particles. The filter or meshcan also be a collection point for collecting air. The cassette havingthe air separation chamber can in one embodiment include indents oralignment apparatuses that ensure that the cassette is aligned properlywithin the dialysis instrument so that a sensor will sense a desiredportion of the cassette. For example, it is contemplated to measure thepressure or level of air in the air separation chamber to know when toopen a vent valve to allow air in the chamber to depressurize. Theindents or alignment apparatuses mate with corresponding apparatuseslocated on the dialysis instrument to ensure that the proper airseparation area of the cassette is aligned with the pressure or levelsensor.

It is accordingly an advantage of the present disclosure to provideimproved air separation chambers for the removal of air from thedialysis fluid or blood flowing through a disposable dialysis fluidapparatus.

Additional features and advantages are described herein, and will beapparent from, the following Detailed Description and the figures.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is an elevation view of one embodiment of a disposable-baseddialysis fluid air separation chamber using a low pressure inlet flow ofdialysis fluid to the air separation chamber.

FIG. 2 is an elevation view of another embodiment of a disposable-baseddialysis fluid air separation chamber using a low pressure inlet flow ofdialysis fluid to the air separation chamber.

FIG. 3 is an elevation view of a further embodiment of adisposable-based dialysis fluid air separation chamber using a lowpressure inlet flow of dialysis fluid to the air separation chamber.

FIGS. 4A and 4B are elevation and top views, respectively, of oneembodiment of a disposable-based dialysis fluid air separation chamberconfigured to cause a serpentine flow of dialysis fluid within the airseparation chamber.

FIGS. 5A and 5B are elevation and top views, respectively, of anotherembodiment of a disposable-based dialysis fluid air separation chamberconfigured to cause a cyclone flow of dialysis fluid within the airseparation chamber.

FIGS. 6A and 6B are elevation and top views, respectively, of a furtherembodiment of a disposable-based dialysis fluid air separation chamberconfigured to cause a cyclone flow of dialysis fluid within the airseparation chamber.

FIGS. 7A and 7B are elevation and top views, respectively, of yetanother embodiment of a disposable-based dialysis fluid air separationchamber configured to cause a cyclone flow of dialysis fluid within theair separation chamber.

FIGS. 8A and 8B are elevation and top views, respectively, of stillanother embodiment of a disposable-based dialysis fluid air separationchamber configured to cause a cyclone flow of dialysis fluid within theair separation chamber.

FIG. 9 is an elevation view of one embodiment of a disposable-baseddialysis fluid air separation chamber configured to cause a nozzled flowleading to a vacuum separation of gas bubbles from dialysis fluid.

FIG. 10 is an elevation view of an embodiment of a disposable-baseddialysis fluid air separation chamber configured to cause a film flow ofdialysis fluid within the air separation chamber.

DETAILED DESCRIPTION

Referring now to the drawings and in particular to FIG. 1, dialysisdisposable, e.g., cassette 10, having air trap 50 illustrates oneembodiment of the present disclosure (air trap 50 refers generally toair traps 50 a to 50 j discussed herein). While air traps 50 are shownherein in connection with a disposable set described below, theseparation chambers are alternatively stand-alone apparatuses thatoperate independent of the disposable cassette.

Dialysis cassette 10 is operable with any type of dialysis instrumentsuch as a peritoneal dialysis instrument, hemodialysis, hemofiltration,hemodiafiltration or continuous renal replacement therapy instrument.Dialysis cassette 10 can hold a dialysis fluid such as dialysate orblood. The dialysis fluid can be premixed or cassette 10 can carry acomponent of dialysate such as a dialysate concentrate.

Dialysis cassette 10 in one embodiment is part of a disposable set whichincludes one or more supply bag, a drain bag, a heater bag, and tubingrunning from those bags (not illustrated) to dialysis cassette 10.Dialysis cassette 10 in one embodiment is disposable, however, dialysiscassette 10 can be cleaned for multiple uses in which the air trapsdescribed herein are used multiple times. Dialysis cassette 10 includesa rigid portion have a cassette top wall 12, a cassette side wall 14 anda cassette bottom wall 16. Suitable materials for the rigid portioninclude polyvinyl chloride (“PVC”), acrylic, ABS, polycarbonate andpolyolefin blends. The rigid portion of cassette 10 also includes a basewall or mid-plane 18 which separates cassette 10 into first and secondsides.

The side of mid-plane 18 illustrated in FIG. 1 includes pump chambers 20a and 20 b which here are part of a pneumatically and/orelectromechanically operated diaphragm pump. Alternatively, cassette 10includes peristaltic pumping tubes that operate with a peristaltic pumpactuator of the dialysis instrument. Cassette 10 also includes valvechambers, such as air separation inlet valve chamber 22, air separationoutlet valve chambers 24 a and 24 b and air separation air vent valvechambers 26 a and 26 b. The valve chambers can also be pneumaticallyand/or electromechanically operated.

The other side of cassette 10 divided by mid-plane 18 (not illustrated)can include flow paths for example and/or other valve chambers and/orpump chambers. It should be appreciated that cassette 10 can havedifferent structural layouts without affecting the performance airseparation chamber 50. Air separation chamber 50 can be located oneither side of mid-plane 18 for space purposes or other reasons relatedto component layout.

In the illustrated embodiment, the rigid portion of cassette 10 definesthe wall or walls of pump chambers 20 a and 20 b that operate with aflexible cassette sheeting 28 which is welded, heat sealed or solventbonded to rigid walls 12, 14, 16, etc., of the rigid portion of cassette10. Suitable cassette sheeting 28 includes polyvinyl chloride (“PVC”),polypropylene/polyethylene blends, polypropylene or Kraton blends,polyester, polyolefin, and ULDPE. The suitable PVC sheeting can include,for example, monolayer PVC films, non-DEHP PVC monolayer films,monolayer non-PVC and multilayer non-PVC films (wherein different layersare chosen to provide strength, weldability, abrasion resistance andminimal “sticktion” to other materials such as rigid cassettematerials). Multiple layers can be co-extruded or laminated together.

Cassette sheeting 28 is also used to open and close valve chambers, suchas chambers 22, 24 a, 24 b, 26 a and 26 b. The dialysis instrumentincludes a processor and memory that operate a program which controlswhen valve chambers 22, 24 a, 24 b, 26 a and 26 b are opened or closed.For example, inlet and outlet valve chambers 22, 24 a and 24 b can besequenced during priming to fill air separation chamber 50. Inlet andoutlet valve chambers 22, 24 a and 24 b are open during dialysis fluiddelivery and/or blood pumping to remove air from those fluids. Whileinlet and outlet valve chambers 22, 24 a and 24 b are shown directly infront of and behind the air separation chambers, it is also contemplatedto move one or both the inlet and outlet valves 22, 24 a and 24 bfurther away from the air separation chamber. One or both of inlet andoutlet valve chambers 22, 24 a and 24 b can be configured to controlflow to multiple places within cassette 10, including the air separationchamber.

The memory and processing are also programmed to operate vent valvechambers 26 a and 26 b so as to remove air from the air separationchamber in a manner that does not affect the sterility of the dialysisfluid flowing through cassette 10. To this end, the processing andmemory can operate with an air pressure signal from a pressure sensor(or level signal from a level sensor) monitoring the pressure of air(level of fluid) within the air separation chamber. The signal ismonitored to determine when to perform the air purge valve sequence ofvalve chambers 26 a and 26 b. Alternatively, the processing and memoryare programmed to perform the valve sequence for valve chambers 26 a and26 b at set intervals.

Cassette 10 in FIG. 1 also includes a plurality of rigid ports extendingfrom one of the walls such as cassette top wall 12. In the illustratedembodiment, cassette 10 includes a vent port 30, which operates withvent valve chambers 26 a and 26 b and air separation chamber 50.Cassette 10 also includes other ports, such as one or more fluid supplyport 32, a drain port 34, a to- or from-heater port 36 and other ports,such as patient port and heater bag port.

Vent port 30 can vent air from air separation chamber 50 to atmosphereor to drain in different embodiments. Cassette 10 can include otherapparatuses (not illustrated) such as pressure sensing areas, heaterflow path areas, and additional pumping areas such as heparin and/orsaline pumping areas.

Cassette 10 further includes alignment notches 42 and 44 that mate withalignment projections 102 and 104 of dialysis instrument 100 whencassette 10 is loaded into instrument 100. Mating apparatuses 42/102 and44/104 (and potentially others, not limited to two) ensure that cassette10 is aligned correctly with corresponding actuators, sensors and otherhardware located within instrument 100. For example, instrument 100 caninclude a level sensor or pressure sensor to sense when air vent valvesshould be sequenced to vent air from the air separation chamber. Matingapparatuses 42/102 and 44/104 ensure that an air collection portion ofthe chamber is aligned properly with the pressure chamber or thatcassette 10 is positioned so that the level sensor reads the level ofdialysis fluid correctly.

FIG. 1 shows one embodiment of the air separation chamber or air trap ofthe present disclosure, namely, air separation chamber 50 a. Airseparation chamber 50 a includes a first side wall 52, a bottom wall 54,an second side wall 56 and a top wall 58.

In general, walls 52 to 58 can extend from mid-plane 18 such thatmid-plane 18 forms one of the broad sides of air separation chamber 50.Alternatively, mid-plane 18 extends along the outside of walls 52 to 58but not inside air separation 50, such that walls 52 to 58 extend theentire width of cassette 10. Here, both broad surfaces of air separationchamber 50 can be made of flexible sheeting 28. Alternatively, one orboth of the broad surfaces of air separation chamber 50 are made of therigid material, wherein sheeting 28 is then welded to the rigid broadsurfaces of air separation chamber 50. For example, the profile shape ofair separation chamber 50 can be welded or solvent bonded to walls 52 to58. Thereafter, the sheeting is welded or solvent bonded to the edges ofthe rigid profile sides of air separation chamber 50. Further, in thecase in which mid-plane 18 forms one of the broad sides of airseparation chamber 50, the outer broad surface of air separation 50 canbe flexible sheet 28 or a rigid piece that is welded or solvent bondedto walls 52 to 58.

Inlet valve chamber 22 opens and closes an inlet pathway 62, whileoutlet valve chambers 24 a and 24 b open and close outlet pathways 64.Inlet pathway 62 communicates with air separation chamber 50 via inlet66 which is formed in bottom wall 54. Outlet pathways 64 communicatewith air separation chamber 50 via outlets 68 also formed in wall 54 ofair separation chamber 50. It should be appreciated that while valvechambers 22, 24 a and 24 b are shown as inlet and outlet valves,respectively, each valve chamber can be either an inlet or outlet valve,e.g., for priming purposes each valve chambers 22, 24 a and 24 b can bean inlet valve chamber that primes air removal chamber 50 up to ventline 70.

Vent valves 26 a and 26 b open and close a vent line 70. Vent line 70communicates with vent port 30 and with air separation chamber 50 via avent outlet 72 formed in top wall 58 of air separation chamber 50. Dualvent valves 26 a and 26 b allow the processing and memory of thedialysis instrument to isolate a slug of air in vent line 70 before ventvalve 26 b is opened, allowing the air to escape via vent port 30 toatmosphere or drain. In the programmed sequence, with vent valve 26 bclosed, vent valve 26 a is opened allowing vent line 70 to becomepressurized with air. Once line 70 becomes pressurized, valve 26 a isclosed and valve 26 b is opened, relieving the pressure in vent line 70.

With air separation chamber 50 a, inlet pathway 62, outlet pathways 64and vent line 70 are at least substantially parallel to each other.Walls 52 and 56 are at least substantially parallel to each other.Bottom wall 54 and top wall 58 are angled to smooth flow and to reducetrapped air. Air separation chamber 50 a can be configured differently.For example, the profile shape can be alternatively substantiallyrectangular, and the inlet pathway 62 and outlet pathways 64 canalternatively extend to side walls 52 and 56. A single outlet 64 andvalve chamber 24 a can be provided instead of two dialysis fluidoutlets.

Inlet pathway 62 of air separation chamber 50 a extends upwardly intothe chamber when cassette 10 is placed into the dialysis instrument.Dialysis fluid flows against gravity g from the opening 66 of inletpathway 62 into the air collection area 84 of the air separationchamber. A splash plate 80 is provided to prevent the dialysis fluidfrom splashing up into vent line 70. The dialysis fluid spills over fromthe top of inlet pathway 62 into dialysis fluid pool 82. The dialysisfluid flows from pool 82, through one or more outlet pathway 64 and tothe patient or elsewhere, e.g., to a fluid heater.

Air separation chamber 50 a promotes air separation through multiplemodes. First, forcing the dialysis fluid to flow over inlet opening 66of inlet tube 62 separates the dialysis fluid, exposing more of itssurface area to the atmosphere. Exposing fluid surface area also exposesgas bubbles trapped within the fluid, allowing the bubbles to escape toair collection portion 84. Second, once the dialysis fluid falls intofluid pool 82, buoyancy forces in the pool push remaining air bubbles upto air collection portion 84.

Air separation chamber 50 b operable with cassette 10 of FIG. 2illustrates another splash and pool embodiment of the presentdisclosure. With air separation chamber 50 b, inlet pathway 62, outletpathways 64 and vent line 70 are again at least substantially parallelto each other. Walls 52 and 56 are also at least substantially parallelto each other. Top wall 58 is angled to smooth flow and reduce thepossibility of trapping air. Bottom wall 54 is angled from inlet 62 tooutlet 64 to allow gravity g to create a generally right-to-left,downward flow. Air separation chamber 50 b can be configureddifferently, for example, the profile shape can be alternativelysubstantially rectangular, or the inlet pathway 62 and outlet pathway 64can alternatively extend to side walls 52 and 56.

Inlet pathway 62 of air separation chamber 50 b extends upwardly intoand along the right side of the chamber 50 a when cassette 10 is placedinto the dialysis instrument. Dialysis fluid flows against gravity gfrom the opening 66 of inlet pathway 62 into the air collection area 84of the air separation chamber. A splash plate 80 is provided to preventthe dialysis fluid from splashing up into vent line 70. The dialysisfluid spills over from the top of inlet pathway 62 and into dialysisfluid pool 82. The dialysis fluid flows from pool 82, through outletpathway 64 and to the patient or elsewhere.

Air separation chamber 50 b, like chamber 50 a, promotes air separationby flowing the dialysis over inlet opening 66, separating the dialysisfluid, exposing more of its surface area to the atmosphere and exposinggas bubbles trapped within the fluid to atmosphere. Moreover, once thedialysis fluid falls into fluid pool 82, buoyancy forces in the poolpush remaining air bubbles up to air collection portion 84.

Air separation chamber 50 c operable with cassette 10 of FIG. 3illustrates a further splash and pool embodiment of the presentdisclosure. With air separation chamber 50 c, inlet pathway 62 and ventline 70 are again at least substantially horizontal and parallel to eachother. Vent line 70 is located elevationally above inlet 62. Outlet 64is disposed vertically and below inlet 62 or vent line 70. Walls 52 and56 are also at least substantially parallel to each other. Top wall 58is angled to smooth flow and to reduce trapped air. Bottom wall 54 isangled from second side 56 to outlet 64 to allow gravity g to create agenerally right-to-left, downward flow.

Dialysis fluid flows horizontally through inlet pathway 62 of airseparation chamber when cassette 10 is placed into the dialysisinstrument. Dialysis fluid flows from the opening 66 of inlet pathway 62into the air collection area 84 of the air separation chamber. Thedialysis fluid hits a splash plate 80 which breaks apart the dialysisfluid. The dialysis fluid spills down from splash plate 80 into dialysisfluid pool 82. The dialysis fluid flows from pool 82, through outletpathway 64 and to the patient or elsewhere.

Air separation chamber 50 c, like chambers 50 a and 50 b, promotes airseparation by impinging the dialysis fluid against splash plate 80 andseparating the dialysis fluid, exposing more of its surface area to theatmosphere and thereby exposing gas bubbles trapped within the fluid toatmosphere. Moreover, once the dialysis fluid falls into fluid pool 82,buoyancy forces in the pool push remaining air bubbles up to aircollection portion 84.

In the following examples the number of baffles and funnels per airseparation chamber can vary from the number illustrated.

Air separation chamber 50 d, operable with cassette 10 of FIGS. 4A and4B, is one embodiment of an air separation chamber that creates aserpentine dialysis fluid flow to separate air and gas bubbles from thedialysis fluid. Inlet pathway 62 and vent line 70 are again at leastsubstantially horizontal and parallel to or aligned with each other.Outlet 64 is disposed vertically at bottom wall 54. Walls 52 and 56 arealso at least substantially parallel to each other. Bottom wall 54 isangled from first side 52 to outlet 64 to allow gravity g to create agenerally left-to-right, downward flow at the bottom of air separationchamber 50 d.

As seen in the top view of FIG. 4B, air separation chamber 50 d canextend from mid-plane 18 or span the entire width of cassette 10. Ifextending from mid-plane 18, the outer surface of air separation chamber50 d can be flexible sheeting 28 (as indicated) or a piece of rigidmaterial. If extending the entire width of cassette 10, the outersurfaces of air separation chamber 50 d can be flexible sheeting 28, twopieces of rigid material, or a combination of same. Thus, depending onthe configuration of air separation chamber 50 d, baffles 80 a to 80 dtogether with any needed support gusseting (not shown) can extend fromsidewalls 52 and 56 or from sidewalls 52 and 56 and mid-plane 18.

Air separation chamber 50 d includes alternating baffles 80 a to 80 d.Each baffle includes or defines an air opening 86 which is surrounded bya border 88 as seen in the top view of FIG. 4B. Baffles 80 a to 80 d donot travel all the way from side wall 52 to side wall 56, but leave agap 90 for the dialysis fluid to fall to the next lower baffle 80 b, 80c or 80 d. Borders 88 prevent, at least partially, dialysis fluid fromfalling though air openings 86 directly to the bottom wall 54. Borders88 also create a central opening for air or gas to travel upwards tovent line 70. Baffles 80 a to 80 d increase the dialysis fluid flow pathand the degassing time as the fluid flows down and back and forth alongthe alternating baffles. Air separation chamber 50 d is structured toforce air towards the middle of the air separation chamber, while thedialysis fluid flows around borders 88. Air separation chamber 50 dachieves back-and-forth if not spiral fluid flow. Air separation isperformed primarily through buoyancy.

Air separation chamber 50 e, operable with cassette 10 of FIGS. 5A and5B, is one embodiment of an air separation chamber that creates acyclone or spiral dialysis fluid flow to separate air and gas bubblesfrom the dialysis fluid. Inlet pathway 62 and vent line 70 are again atleast substantially horizontal and parallel to or aligned with eachother. Outlet 64 is disposed vertically at bottom wall 54. Walls 52 and56 are also at least substantially parallel to each other. Bottom wall54 is angled from second side 56 to outlet 64 to allow gravity g tocreate a generally right-to-left, downward flow at the bottom of airseparation chamber 50 e.

As seen in a top view of FIG. 5B, air separation chamber 50 e can extendfrom mid-plane 18 or span the entire width of cassette 10. If extendingfrom mid-plane 18, the outer surface of air separation chamber 50 e canbe flexible sheeting 28 (as indicated) or a piece of rigid material. Ifextending the entire width of cassette 10, the outer surfaces of airseparation chamber 50 e can be flexible sheeting 28, two pieces of rigidmaterial, or a combination of same. Thus, depending on the configurationof air separation chamber 50 e, baffles 80 a to 80 e together with anyneeded support gusseting (not shown) can extend from sidewalls 52 and 56or from sidewalls 52 and 56 and mid-plane 18.

Air separation chamber 50 e includes alternating baffles 80 a to 80 e.Each baffle has a width w of less than half a total width W of airseparation chamber 50 e. Thus, alternating pairs of baffles leave an airgap 86 between the baffles. The baffles 80 a to 80 e extend from side 52to side 56 and include a turn 92 that directs fluid onto the next lowerbaffle 80 b to 80 e. Each baffle 80 a to 80 e includes a border 94 thatbends with turn 92 and that prevents, at least partially, dialysis fluidfrom falling though air gap 86 directly to the bottom wall 54.Successive gaps 86 create a central opening for air or gas to travelupwards to vent line 70.

Baffles 80 a to 80 e increase the dialysis fluid flow path and thedegassing time as the fluid flows down and back-and-forth along thealternating baffles. Air separation chamber 50 e is structured to forceair towards the middle of the air separation chamber while the dialysisfluid flows around borders 94. Air separation chamber 50 d achievesback-and-forth and spiral fluid flow. The spiraling flow is assumed toproduce a centripetal effect in which heavier fluid gravitates to theoutside of baffles 80 a to 80 e, while lighter air separates towards theinside of the baffles and rises through gaps 86. Air separation isperformed additionally through buoyancy via the elongated fluid flowpath.

Air separation chamber 50 f, operable with cassette 10 of FIGS. 6A and6B, is another embodiment of an air separation chamber that creates acyclone or spiral dialysis fluid flow to separate air and gas bubblesfrom the dialysis fluid. Here, chamber 50 f includes dual inlet valvechambers 22 a and 22 b, which open and close dual inlet pathways 62 aand 62 b respectively. Chamber 50 f creates dual spiraling paths usingdual inlet pathways 62 a and 62 b which are least substantiallyhorizontal and parallel to or aligned with each other. Vent line 70 islocated at top wall 58 of chamber 50 f. Outlet 64 is disposed verticallyat bottom wall 54. Walls 52 and 56 are at least substantially parallelto each other. Bottom wall 54 is dual-angled from sides 52 and 56 tooutlet 64 in the middle of chamber 50 f.

As seen in a top view of FIG. 6B, air separation chamber 50 f can extendfrom mid-plane 18 or span the entire width of cassette 10. If extendingfrom mid-plane 18, the outer surface of air separation chamber 50 f canbe flexible sheeting 28 (as indicated) or a piece of rigid material. Ifextending the entire width of cassette 10, the outer surfaces of airseparation chamber 50 f can be flexible sheeting 28, two pieces of rigidmaterial, or a combination of same. Thus, depending on the configurationof air separation chamber 50 f, rear baffles 80 b, 80 d, 80 f and 80 htogether with any needed support gusseting (not shown) can extend fromsidewalls 52 and 56 or from sidewalls 52 and 56 and mid-plane 18.Baffles 80 a, 80 c, 80 e and 80 g extend from sidewalls 52 and 56,including any needed support gusseting (not shown).

Air separation chamber 50 f includes dual pairs of alternating baffles80 a to 80 h. One pair of alternating baffles includes baffles 80 a, 80c, 80 e and 80 g. The other pair of alternating baffles includes baffles80 b, 80 d, 80 f and 80 h. The two pairs spiral around one another. Eachbaffle has a width w of approximately or slightly less than half a totalwidth W of air separation chamber 50 f. The dual alternating pairs ofbaffles leave air paths from bottom to top indicated by the arrows inFIG. 6A. That is, air weaves up around the alternating plates on theleft and right side of chamber 50 f. The baffles 80 a to 80 h extendfrom side 52 to side 56. Turns 92 and borders 94 (as illustrated inFIGS. 5A and 5B) are not provided in the illustrated embodiment but mayin some form be provided if desired.

Baffles 80 a to 80 h increase the dialysis fluid flow path and thedegassing time as the fluid flows down and back-and-forth along the dualsets of spiraling baffles. Air separation chamber 50 f achievesback-and-forth and spiral fluid flow. The spiraling flow is againassumed to produce a centripetal effect in which heavier fluidgravitates to the outside of baffles 80 a to 80 h, while lighter airseparates towards the inside of the baffles. Air separation is performedadditionally through buoyancy via the elongated dual fluid flow paths.

Air separation chamber 50 g, operable with cassette 10 of FIGS. 7A and7B, is another embodiment of an air separation chamber that creates acyclone or spiral dialysis fluid flow to separate air and gas bubblesfrom the dialysis fluid. Air separation chamber 50 g includes an upperinlet pathway 62, a vent line 70 located at top wall 58 of chamber 50 g,and an outlet 64 disposed vertically at bottom wall 54. Walls 52 and 56are at least substantially parallel to each other. Bottom wall 54 isdual-angled from sides 52 and 56 to outlet 64 located in the middle ofchamber 50 g.

Air separation chamber 50 g creates a series of cyclones via matingpairs of four-sided flow funnels 80 a to 80 c that funnel dialysis fluidin a cyclone manner through a central hole 81 in each funnel and aroundan air column 98 of an associated baffle 96 a to 96 c. Baffles 96 a to96 c receive the dialysis fluid from the central hole 81 of each funnel80 a to 80 c and spread the dialysis fluid outwardly for the nextfunneling of the dialysis fluid. That is, baffle 96 a funnels dialysisfluid to funnel 80 b; baffle 96 b funnels dialysis fluid to funnel 80 c;and baffle 96 c funnels dialysis fluid to bottom wall 54. Theillustrated embodiment accordingly includes four separate funnels orcyclones from funnels 80 a to 80 c and bottom wall 54.

As seen in a top view of FIG. 7B, air separation chamber 50 g can extendfrom mid-plane 18 or span the entire width of cassette 10. If extendingfrom mid-plane 18, the outer surface of air separation chamber 50 g canbe flexible sheeting 28 (as indicated) or a piece of rigid material. Ifextending the entire width of cassette 10, the outer surfaces of airseparation chamber 50 g can be flexible sheeting 28, two pieces of rigidmaterial, or a combination of same. Thus, depending on the configurationof air separation chamber 50 g, funnels 80 a to 80 c and baffles 96 a to96 c together with any needed support gusseting (not shown) can extendfrom sidewalls 52 and 56 or from sidewalls 52 and 56 and mid-plane 18.

In the illustrated embodiment, baffles 96 a to 96 c are fixed within airseparation chamber 50 g via support walls 102. Funnels 80 a to 80 c arefour sided as seen in FIG. 7B, with side 104 a attached to wall 52 andside 104 c attached to wall 56. Sides 104 b and 104 d can be attached torigid pieces (e.g., wall 104 d to mid-plane 18), fixed to flexiblesheets 28 or press-fit against flexible sheets. FIG. 7B also shows inlet62 offset from center to project dialysis fluid into air separationchamber 50 g at wall 104 b in order to aid in the formation of the firstcyclone flow through funnel 80 a.

The arrangement of air separation chamber 50 g produces an elongatedflow path of dialysis fluid as indicated by the arrowed solid line inFIG. 7A. The fluid is forced through multiple funnels, each separatingair form the fluid. Air is encouraged through a central air columnformed by the series of columns 98 of baffles 96 a to 96 c. Thespiraling flow of each funnel is again assumed to produce a centripetaleffect in which heavier fluid gravitates to the outside of the funnels,while lighter air separates towards the inside of the funnels. Airseparation is performed additionally through buoyancy via the elongatedseries fluid flow pathway.

Air separation chamber 50 h, operable with cassette 10 of FIGS. 8A and8B, is another embodiment of an air separation chamber that creates acyclone or spiral dialysis fluid flow to separate air and gas bubblesfrom the dialysis fluid. Air separation chamber 50 h includes un upperinlet pathway 62, a vent line 70 located at top wall 58 of chamber 50 h,and an outlet 64 disposed vertically at the bottom of the air separationchamber 50 h. Walls 52 and 56 as shown angle inwardly towards each otherfrom top wall 58 in a funnel-like manner. FIG. 8A also shows that walls52 and 56 are curved to form an oval or elliptical shape with cassettesheeting 28 when the sheeting is sucked outwardly as discussed below.

As seen in a top view of FIG. 8B, air separation chamber 50 h spans theentire width of cassette 10. The outer surfaces of air separationchamber 50 h are flexible sheeting 28 that is welded, adhered, solventbonded, etc. to side walls 52 and 56. Cassette 10 is loaded intodialysis instrument 100 such that instrument chamber forming shells 106a and 106 b, each having a pneumatic port 108, come into operableengagement with sheeting 28 on respective sides of air separationchamber 50 h of dialysis cassette 10.

In operation, dialysis instrument 100 induces a vacuum at ports 108 ofchamber forming shells 106 a and 106 b which pulls sheeting 28 on bothsides of cassette 10 at the air separation chamber 50 h against theinner walls of shells 106 a and 106 b. The shape of shells 106 a and 106b in combination with the rounded surfaces of side walls 52 and 56 forma funneled oval or elliptical-like volume that is very conducive toforming a funneled, cyclone flow of dialysis fluid. The funneled cycloneof dialysis fluid flows from inlet 62, around and around the sheeting 28and side walls 52 and 56 and down to outlet 24. To aid in forming thecyclone flow, inlet 62 is angled or jogged at side wall 52 in order toinject flow initially towards one of the extended sheets 28. Althoughnot illustrated, side walls 52 and 56 can have baffles or flow directorsto either obstruct the cyclone or to aid the cyclone as desired.

The arrangement of air separation chamber 50 h produces an elongatedflow path of dialysis fluid. Air is encouraged to move upwardly at thecenter of the chamber. The spiraling flow is again assumed to produce acentripetal effect in which heavier fluid gravitates to expandedsheeting 28, while lighter air separates at the center of chamber 50 h.Air separation is performed additionally through buoyancy via theelongated spiraled fluid flow pathway.

Air separation chamber 50 i, operable with cassette 10 of FIG. 9,illustrates one embodiment of a venturi or negative pressure airseparation chamber that pulls fluid under a vacuum within a closedvolume “away from” entrained air, leaving air in the volume. Airseparation chamber 50 i includes inlet pathway 62 leading to side wall52. Sidewall 52 is configured to expand the inlet flow of dialysis fluidto a beginning of a nozzle section of chamber 50 i which is formed viatop wall 58 and bottom wall 54. Walls 52 to 58 can be cylindrical orrectangular in cross-section as desired and formed of only rigidmaterial or rigid material in combination with sheeting 28. For example,top wall 58 and bottom wall 54 can come together to form a cylindricalnozzle section. Alternatively, wall 58 and bottom wall 54 can be curved(similar to walls 52 and 56 of chamber 50 h) together with nozzle andflexible sheeting side walls 28 (which can be sucked outwardly to haverounded surfaces as shown in connection with chamber 50 h).

The nozzle section of chamber 50 i narrows towards exit pathway 64 andexit valve 24. Narrowed exit pathway 64 is placed in fluid communicationwith a fixed volume bulb 110. The nozzle is constructed such that it cancreate a vacuum. Bulb 110 has a large enough volume so as not tonecessitate drainage by a few milliliters. Conversely, the cross-sectionof narrowed exit pathway 64 can be rather small in relation to bulb 110.Fixed volume bulb 110 is either entirely rigid or made with sheetingthat is sucked against instrument 100 to form a fixed volume. Dialysisfluid 82 that rises within fixed volume bulb 82 is subject to negativepressure due to a venturi effect of the nozzled flow through outlet 64.The negative pressure placed on fluid 82 tends to create a negativepressure in air collection portion 84 of bulb 110. The negative gagepressure has two effects on the air separation. First, such pressurewill withdraw dissolved gases out of solution due to changes in thesolubility and introduce the dissolved gases to the buoyant environmentwithin bulb 110. Second, bubble of known size d1 will increase indiameter d2 (where d2>d1), allowing for faster rise times for thebubbles in the appropriate flow environment. Chamber 50 i can becombined with a buoyancy pool (like below) if needed to separate risablebubbles not collected in bulb 110.

Air separation chamber 50 j, operable with cassette 10 of FIG. 10,illustrates one embodiment of a film-producing/buoyancy pool airseparation chamber. Here, inlet line 62 forms a thin fluid path, e.g.,such as a thin liquid film that is 0.5″ wide (12 mm wide) and 0.02″thick (0.5 mm wide), which produces a thin film or stream of fluidexiting opening 66 into a collection volume 112 having a liquid pool 82and air collection area 84. Forcing the inlet to flow into a thin filmor stream increases the exposed surface area of the dialysis fluid andpromotes air separation as described above. The thin film will alsoensure bubbles larger than the size of the film thickness will explodeon their way to the collection chamber and become eliminated. The largerbubbles will be eliminated due to size exclusion and/or explosion. Thiswill break some of the bubbles into smaller bubbles but some bubbleswill explode into the free air space, becoming eliminated from thesolution pool. Residual air not removed via the filming of the dialysisfluid is removed in pool 82 via buoyancy forces as described above.

It should be understood that various changes and modifications to thepresently preferred embodiments described herein will be apparent tothose skilled in the art. Such changes and modifications can be madewithout departing from the spirit and scope of the present subjectmatter and without diminishing its intended advantages. It is thereforeintended that such changes and modifications be covered by the appendedclaims.

1. A dialysis system comprising: a blood disposable operable with adialysis instrument, the blood disposable including a dialyzer, apumping portion configured and arranged to be operated by a blood pumpof the dialysis instrument, and an air separation chamber in fluidcommunication with the pumping portion, the air separation chamberincluding an inner surface, a blood inlet and a blood outlet, andwherein the pumping portion is configured to be actuated to pump bloodthrough the dialyzer and the air separation chamber, and the airseparation chamber is configured to cause the blood to spiral around theinner surface toward the blood outlet to remove air from the blood. 2.The dialysis system of claim 1, wherein the inner surface of the airseparation chamber is curved.
 3. The dialysis system of claim 1, whereinthe inner surface of the air separation chamber is configured to promotethe spiraling of the fluid.
 4. The dialysis system of claim 1, whereinthe fluid inlet is located near a top of the air separation chamber andthe fluid outlet is located near a bottom of the air separation chamberwhen in operation.
 5. The dialysis system of claim 1, wherein the airseparation chamber further includes a vent outlet located near a top ofthe air separation chamber when in operation.
 6. The dialysis system ofclaim 1, wherein the fluid inlet is disposed so as to direct the fluidin a direction promoting the spiraling of the blood.
 7. The dialysissystem of claim 1, wherein the air separation chamber in operation isdisposed so that the blood spirals in an overall downward verticaldirection, and wherein the blood inlet is disposed to direct the bloodhorizontally into the air separation chamber.
 8. The dialysis system ofclaim 1, wherein the inner surface is smooth.
 9. A dialysis system ofclaim 1, wherein the air separation chamber includes at least oneinternal structure configured and arranged to promote the spiraling ofthe blood.
 10. The dialysis system of claim 1, wherein the blooddisposable further includes a first blood pathway between the pumpingportion and the dialyzer and a second blood pathway between the dialyzerand the air separation chamber.
 11. The dialysis system of claim 1,wherein the blood disposable includes a disposable cassette having atleast one rigid wall and at least one flexible sheet.
 12. The dialysissystem of claim 1, wherein the inner surface forms a sidewall of the airseparation chamber.
 13. The dialysis system of claim 12, wherein thesidewall is configured so as to cause the fluid to spiral in an overalldownward vertical direction.
 14. A dialysis system comprising: adialysis instrument including a blood pump actuator; a blood disposableoperable with the dialysis instrument, the blood disposable including anair separation chamber and a blood pumping portion operable with theblood pump actuator, the air separation chamber including a blood inletand a blood outlet communicating fluidly with an inner surface of theair separation chamber, the inner surface configured to promote thespiraling of a blood to remove air from the blood.
 15. The dialysissystem of claim 14, wherein a fluid valve is in fluid communication withone of the blood inlet, the blood outlet or a vent of the air separationchamber.
 16. The dialysis system of claim 14, wherein the blood inlet isdisposed so as to direct the blood in a direction promoting thespiraling of the blood along the inner surface.
 17. The dialysis systemof claim 14, which includes at least one internal structure operatingwith the inner surface to promote the spiraling of the blood.
 18. Amethod of removing air from a dialysis system comprising: introducingblood potentially containing air horizontally into an upper portion of achamber of a blood disposable, the blood disposable including a bloodpumping portion and a dialyzer; forcing the blood potentially containingair to spiral around the chamber from the upper portion to a lowerportion of the chamber; and allowing the blood to exit from the lowerportion of the chamber and air to migrate towards the upper portion ofthe chamber.
 19. The method of claim 18, which includes allowing the airto migrate towards the upper portion of the chamber centrally throughthe spiraling blood.
 20. The method of claim 18, which includes allowingair to be removed from the upper portion of the chamber.